Cure Insomnia

Insomnia is the inability to fall asleep and/or get enough sleep, which can eventually cause many physical and emotional problems. It's estimated that approximately 95% of Americans deal with bouts of insomnia during their lifetime. Insomnia can be acute (short-term) or chronic (ongoing). Acute insomnia may last for days or weeks. It is often caused by moderate-to-severe stress (usually from financial, health, and/or relationship problems), although other factors such as dietary and medical issues can play significant roles also. Chronic insomnia lasts for a month or longer. Curing both acute and chronic insomnia often requires a multi-factorial approach including reviewing your medications and daily routines as well as changing your sleeping habits and diet.

Steps

Improving Your Sleeping Habits

1. Make your bedroom comfortable. To help cure your insomnia, make your bedroom or sleeping area as inviting and calm as possible. Your environment should also be relatively quiet, although many people can get accustomed to some background noise. Focus on the comfort of your sleeping area and save your bed for only sleep, sex and light reading (not eating, studying, watching TV, texting on your phone or paying bills) as it can lead to higher quality and duration of sleep.
   • If you live in a noisy neighborhood, consider wearing earplugs or buying a white noise machine. White noise (like the sound of static) drowns out other more distracting noises.
   • Make your bed with comfortable sheets that don't make you too hot or cold at night. In general, try to keep your room cool — around 60 - 65°F (though this may be too cold or impractical for some).
   • Wait until you're comfortably drowsy to go to bed and don't try too hard to fall asleep. If you can't sleep, get out of bed after 20 minutes and do something relaxing.
2. Make your bedroom dark. For your body to think that it's time to fall asleep, your sleeping environment has to be relatively dark, although many people can get accustomed to some amount of light. Darkness triggers the release of hormones, such as melatonin, in your brain that initiate the "sleep cascade" and promote deep sleep. As such, close all your blinds and turn off all sources of illumination that your can see from your bed. Don't browse the internet on your phone while in bed, as the bright screen can make you more alert and less drowsy.
   • Use thick black-out shades to prevent light from coming in through your windows, or wear a sleep mask over your eyes.
   • Avoid bright (and noisy) alarm clocks and remove them from view. Once you set your alarm, hide your clock so the light and time don't distract you. Watching the time can increase anxiety and make insomnia worse.
3. Develop relaxing bedtime rituals. It's important to develop relaxing rituals in the latter part of the evening to prepare your mind and body for sleep. Work, school, exercise, paying the bills and preparing meals can all be stressful, so having activities to help you unwind before bedtime can help promote better sleep and either combat insomnia or reduce the risk of it developing. Various relaxation techniques are proven to calm the brain and body, such as progressive muscle relaxation and deep breathing techniques.
   • Progressive muscle relaxation or PMR teaches you how to relax your muscles through a 2- step process: first, you intentionally tense muscle groups in your body, such as your neck and shoulders; next, you release the tension, focusing intensely on one body part at a time. Try this each night before bedtime.
   • Deep breathing techniques prior to bed can help you relax and get to sleep. Place a hand on your lower abdomen and breathe in deeply so your hand rises (called stomach breathing). Hold your breath for a count of three and then exhale fully and watch your hand fall. Do these 3x per night.
   • A warm bath can also help cure insomnia. Make sure the water isn't too hot and add a couple scoops of Epsom salts — it's rich with magnesium, which can absorb through your skin and relax muscles. Light some candles. Soak in the tub for 20-30 minutes while reading something light and funny.
   • Avoid doing anything too stimulating or stressful on the computer (or phone) and don't watch scary or action movies that get your adrenaline going.
4. Don't go to bed hungry. Don't eat right before bed because it can lead to a burst of energy (a sugar rush, for example) and increase your risk of painful heartburn — but going to bed hungry can also keep you up. A grumbling stomach and hunger pains distracts from sleep and helps to promote insomnia, especially if your mind is fixated on food. As such, don't go much more than 3-4 hours without food before going to bed.
   • If you need a snack after dinner, stick to healthy and light stuff, such as fruit, veggies, low-fat dairy and whole grains.
   • Some foods, especially poultry, contain amino acids (tryptophan and glutamine) that promote sleepiness. Thus, consider having a turkey sandwich on whole grain bread for an evening snack.
   • Avoid eating snacks, particularly spicy stuff, within an hour of bedtime. This strategy will let your GI system properly digest the food and allow for any energy rush to subside.

Making Lifestyle Changes

1. Reduce your stress levels. Concerns with finances, work, school, relationships and your general social life often lead to stress, which can trigger short-term or long-term insomnia. Trying to reduce or manage your daily stressors promotes better sleep and help to cure insomnia. Don't be afraid to make significant life changes to free yourself from stressful situations, because insomnia is only one symptom of chronic stress — anxiety attacks, depression, headaches, high blood pressure and heart disease are others.
   • Be reasonable about your obligations and responsibilities. Many people get stressed because they are over-committed or over-scheduled. Don't promise what you can't reasonably deliver.
   • Feel free to reduce contact with people who bring you lots of stress.
   • Manage your time better. If running late causes you stress, leave for work a little early each day. Plan ahead and be realistic.
   • Use moderate exercise to handle stress instead of binge eating. People who are stress tend to binge eat on "feel good" food, but this can lead to weight gain and depression. Instead, be active and go exercise when stressed out (see below).
   • Talk to friends and family members about stressful issues. Simply venting about your stressful issues can help. If no one is around, write your feelings down in a journal.
2. Exercise regularly during the day. Regular physical activity during the daytime can help regulate your sleep cycle at night, which is a good strategy for combating insomnia. It can give you a boost of energy and invigorate you initially, but the strenuous effort and increased breathing of oxygen makes you tired and sleepy at night. If you don't have a regular exercise routine already, strive for at least 30 minutes of aerobic activity (walking, hiking, biking, swimming) per day.
   • Establishing an exercise routine takes effort. Try to be active at the same time each day, either early in the morning, during your lunch break, or right after work before you eat.
   • Exercise also promotes weight loss, which can reduce annoying aches and pain, make you more comfortable in bed at night, and reduce the risk of snoring and other breathing problems.
   • Don't engage in vigorous exercise too close to bedtime because your body produces adrenaline and it will prevent you from falling asleep quickly. Make sure your workouts occur 5-6 five hours prior to bedtime.
3. Cut down on alcohol. While alcohol may help some people fall asleep faster, it can disrupt sleep patterns and reduce the quality of your sleep. You may even find yourself waking up in middle of the night and struggling to fall asleep again. Cut down on the amount of alcohol that you drink, and stop consuming any alcoholic drinks at least an hour before you go to bed.
4. Quit using nicotine. Nicotine is a stimulant, and it can keep you awake if used too close to your bedtime. Nicotine is most commonly found in cigarettes. Since smoking is bad for your health, you should try to quit smoking entirely.
   • If you are still using nicotine products, stop smoking or chewing nicotine gum a few hours before bedtime.
   • Nicotine is found in cigarettes, cigars, and smokeless tobacco. There are also nicotine patches and chewing gums meant to help you quit smoking. These can all make it more difficult for you to sleep.
5. Don't consume caffeine before bedtime. Caffeine is a stimulant that can disturb sleep in people. The effects can last as long as 8 hours. Thus, as a general rule, avoid caffeine anytime after lunch.
   • Caffeine increases the activity of brain neurons, which may cause your mind "to race" with more thoughts and ideas.
   • Coffee, black tea, green tea, hot chocolate, dark chocolate, colas, some other sodas and virtually all energy drinks are significant sources of caffeine. Some cold medications also contain caffeine.
   • Keep in mind that sugar (especially the heavily processed types) is also a stimulant and should be avoided for at least an hour before heading to bed.

Seeking Professional Help

1. Schedule an appointment with your doctor. If some short-term sleeplessness has transitioned into full-blown insomnia (despite your efforts with lifestyle changes), then make an appointment with your doctor. Your doctor will try to determine if you have an underlying medical condition that's causing or contributing to your insomnia. If so, then treatment should focus on the underlying heath condition first and the sleeping difficulty should then fade away secondarily.
   • Common causes of insomnia include: chronic pain, depression, restless leg syndrome, sleep apnea (severe snoring), bladder control problems, arthritis, cancer, hyperthyroidism (overactive thyroid), menopause, heart disease, lung disease, and chronic heartburn.
   • Ask your doctor if any of your prescription drugs can potentially trigger insomnia — problematic drugs include those used for depression, hypertension, allergies, weight loss and ADHD (such as Ritalin).
   • Check the labels of any medications you take regularly. If they contain caffeine or stimulants like pseudoephedrine they may be causing your insomnia.
2. Ask your doctor about pharmaceutical sleep aids. If your doctor thinks it's necessary or helpful, they may prescribe medication to help you get to sleep. Some drugs are better for short-term insomnia (recently acquired), whereas others are more powerful and better for long-term (chronic) insomnia. Most doctors don't prescribe drugs for insomnia in conjunction with different drugs to treat other underlying medical issues. Mixing different drug classes increases the risk of side effects (see below).
   • First-choice sleeping pills for short-term insomnia include eszopiclone, ramelteon, zaleplon and zolpidem.
   • Additional prescription medications used to treat insomnia include diazepam, lorazepam, and quazepam.
   • Note that some insomnia medications can be habit-forming and may come with unpleasant side effects, including low blood pressure, nausea, anxiety, daytime drowsiness, and sleepwalking.
3. Consider cognitive behavioral therapy (CBT). Get a referral to a psychologist or therapist who practices CBT, which can be helpful in relieving insomnia. CBT is used to negate factors that exacerbate insomnia, such as negative thoughts, poor sleep habits, irregular sleep schedules, poor sleep hygiene and misunderstandings about sleep. CBT represents a good option if you want an effective medical treatment, but are not interested in sleeping pills.
   • CBT can involve sleep education, info on sleep hygiene, relaxation training, cognitive control, psychotherapy and/or biofeedback.
   • CBT promotes behavioral changes by getting you to keep regular bedtimes and wake-up times, as well as eliminating afternoon naps.
   • Your CBT therapist will work with you to help control or eliminate negative thoughts, worries and any false beliefs that are causing sleeplessness.
   • If you can't get a referral from your doctor, you should be able to find a list of CBT providers through your insurance.
4. Get a referral to a sleep clinic. If you have chronic (long-term) insomnia that's not going away after implementing the above-mentioned advice, then get a referral from your doctor to a sleep clinic. Sleep clinics are run by doctors, nurses, psychologists and other health professionals with specialized training in sleeping disorders and remedies. You'll sleep overnight in the clinic while hooked up to various devices (such as a polysomnogram) that monitor your brain waves and level of consciousness.
   • People with chronic insomnia usually don't experience much or any time in the REM (rapid eye movement) phase of sleep compared to people who sleep normally.
   • REM sleep should occur about 90 minutes after falling asleep — intense dreams happen in this stage.
   • People with insomnia also have difficulty initiating non-REM sleep to start with, but once there, often don't transition to deep non-REM and finally REM sleep.

Experimenting with Alternative Therapies

1. Try natural sleep aids. There are many plant-based remedies or natural supplements that act as mild sedatives and help to cure insomnia if there isn't an underlying medical condition. Natural herbal medicine is generally very safe in terms of toxicity if you follow instructions on the label. They also don't lead to the potentially serious side effects that many sleeping pills do. The most commonly used natural sleep aids are valerian root, chamomile, and melatonin.
   • Valerian root has a mild sedating effective on people, which leads to sleepiness. You can take it as a capsule or drink it as a herbal tea for 1-2 weeks at a time. In very high doses, valerian root can have a negative effect on the liver.
   • Chamomile flower is also a mild sedative that can calm the nerves, promote relaxation and trigger sleepiness. Chamomile tea is very popular and should be drank about an hour before bedtime.
   • Melatonin is a hormone made by the pineal gland in your brain. It's essential for circadian rhythm and triggering deep sleep at night when it's dark. Taking it as a supplement can potentially help with insomnia, although research is currently inconclusive.
2. Use aromatherapy for relaxation. Aromatherapy is using the scents of essential oils and other plant oils to create a calming effect. Aromatherapy cannot cure insomnia or any of its root causes, but it can create relaxation and induce a better frame of mind to fall asleep and stay asleep. Common essential oils used for aromatherapy and recommended for relaxation include lavender, rose, orange, bergamot, lemon, sandalwood and others. It is thought lavender may stimulate the activity of brain cells in the amygdala, similar to the way some sedative medications work.
   • Breathe in essential oils directly from a piece of tissue / cloth or indirectly through steam inhalations, vaporizers or sprays. You can also mix essential oils into your bath water.
   • Start an aromatherapy session about 30 minutes prior to bedtime. If you buy a special vaporizer, let it run throughout the night.
   • Some candles are infused with essential oils, but never let candles burn unattended or while you're asleep.
   • Aromatherapists, nurses, chiropractors, massage therapists and acupuncturists are often the health professionals who practice aromatherapy.
3. Experiment with acupuncture treatments. Acupuncture involves sticking very thin needles into specific energy points within your skin / muscle in efforts to stimulate the flow of energy in your body and reduce a variety if symptoms. Acupuncture for insomnia is not well researched, but some people claim it can be very relaxing and calming, as well as eliminate pain. Based on the ancient principles of traditional Chinese medicine, acupuncture may work by releasing a variety of pain-relieving and "feel good" substances, including endorphins and serotonin.
   • Acupuncture can increase night-time melatonin production, which can help treat patients with anxiety-induced insomnia.
   • It's likely best to look into acupuncture treatment for insomnia if other methods (mentioned above) don't work.
   • Acupuncture is practiced by a variety of health professionals including some physicians, chiropractors, naturopaths, physiotherapists and massage therapists — whoever you choose should be certified by NCCAOM.
4. Look into hypnotherapy. As a last resort for trying to cure your insomnia, consider hypnotherapy. Hypnotherapy involves changing your level of consciousness so that you're relaxed and very suggestible. Once in this altered state, the hypnotherapist can give you suggestions or commands that can help you relax, reduce anxious thoughts, change perceptions and prepare your body for sleep. This can potentially help all sorts of insomniacs, but it's important to understand it doesn't cure any underlying diseases or conditions that contribute to insomnia.
   • Get a referral to someone reputable who practices hypnotherapy and be sure to ask for their credentials and licensing information.
   • A growing number of physicians, psychologists, psychologists and counselors practice hypnotherapy.
   • Always take a friend or family member with you (at least initially) because people are very vulnerable once hypnotized.

Tips

• Most people need between 7-9 hours of sleep per night, although some can get by with as little as 3 hours without exhibiting any negative side effects.
• Jet lag from traveling long distances and dealing with time changes can trigger short-term insomnia.
• Taking an over-the-counter antihistamine can cause drowsiness, which may help you fall asleep if you're experiencing insomnia.
• Chronic long-term insomnia is usually linked to an underlying mental or physical problem. Mental conditions commonly responsible for sleeplessness include depression, bipolar disorder, post-traumatic stress disorder and chronic anxiety.
• Sometimes simply reading a book can help, also try to avoid stress. To do that, meditate or do a fun activity. This can help you sleep better at night.

Warnings

• Clinical depression is a common cause for insomnia and should not be self-treated. See your doctor or a licensed therapist qualified to deal with depression

Sources and Citations

See also

• Recognize Symptoms of Sleep Apnea
• Have Lots of Energy After Having Little Sleep
• Stop Snoring
• Prevent Insomnia
• Avoid Sleeping and Yawning During the Day
• Cope with Sleep Paralysis
• Deal with Sleep Apnea
• Stop Snoring Naturally
• Know if You Have Insomnia
• Start Sleeping Without Prescription Sleep Pills

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